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The prepuce: specialized mucosa of the penis and its loss to circumcision

J.R. Taylor MB, ChB, MRCPEd, FRCPC, Pathologist.

Department of Pathology, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada

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A.P. Lockwood MD, FRCSC, Plastic Surgeon.

Department of Pathology, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada

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A.J. Taylor RT, Pathology Assistant.

Department of Pathology, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada

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First published: February 1996
Cited by: 103
Dr J.R. Taylor Department of Pathology, Health Sciences Centre, University of Manitoba, 770 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E OW3

Abstract

Objective To assess the type and amount of tissue missing from the adult circumcised penis.

Materials and methods The gross and histological features of the prepuces of 22 adults obtained at autopsy were assessed, primarily focusing on the inner or mucosal surface of the prepuce.

Results Skin and mucosa sufficient to cover the penile shaft was frequently missing from the circumcised penis. Missing tissue included a band of ridged mucosa located at the junction of true penile skin with smooth preputial mucosa. This ridged band contains more Meissner's corpuscles than does the smooth mucosa and exhibits features of specialized sensory mucosa.

Conclusion The amount of tissue loss estimated in the present study is more than most parents envisage from pre‐operative counselling. Circumcision also ablates junctional mucosa that appears to be an important component of the overall sensory mechanism of the human penis.

Number of times cited: 103

  • , Factors Associated With Early Deaths Following Neonatal Male Circumcision in the United States, 2001 to 2010, Clinical Pediatrics, 10.1177/0009922818790060, 57, 13, (1532-1540), (2018).
  • , Attitude Toward One’s Circumcision Status Is More Important than Actual Circumcision Status for Men’s Body Image and Sexual Functioning, Archives of Sexual Behavior, (2017).
  • , Negotiating masculinities and authority through intersecting discourses of tradition and modernity in South Africa, NORMA, 12, 1, (38), (2017).
  • , Die nicht-retrahierbare Vorhaut bei beschwerdefreien Jungen, Der Urologe, 56, 3, (351), (2017).
  • , Nerves in the cavernous tissue of the glans penis: An immunohistochemical study using elderly donated cadavers, Journal of the Anatomical Society of India, 66, 2, (91), (2017).
  • , Circumcision, Autonomy and Public Health, Public Health Ethics, (2017).
  • , The prevalence of an excessive prepuce and the effects of distal circumcision on premature ejaculation, Arab Journal of Urology, 15, 2, (140), (2017).
  • , False beliefs predict increased circumcision satisfaction in a sample of US American men, Culture, Health & Sexuality, (1), (2017).
  • , La circoncision : une mutilation ?, Sexologies, 26, 3, (161), (2017).
  • , Examining Penile Sensitivity in Neonatally Circumcised and Intact Men Using Quantitative Sensory Testing, The Journal of Urology, 195, 6, (1848), (2016).
  • , Caudal and Penile Blocks Demonstrate Similar Reliability and Efficacy in Pediatric Patients Undergoing Circumcision: A Meta-Analysis, International Journal of Clinical Medicine, 07, 05, (309), (2016).
  • , Medical perspectives on the clinical value of male circumcision, Journal of the Korean Medical Association, 59, 10, (785), (2016).
  • , Seroprevalence of cutaneous human papillomaviruses (HPVs) among men in the multinational HPV Infection in Men study, Journal of General Virology, 97, 12, (3291), (2016).
  • , Circumcision Is Unethical and Unlawful, The Journal of Law, Medicine & Ethics, 44, 2, (263), (2016).
  • , Anatomy of the cutaneous surface of the male genitalia, with elaboration upon the inner preputial coronal-shaft junction, Journal of Pediatric Urology, 12, 1, (53.e1), (2016).
  • , Histological Correlates of Penile Sexual Sensation: Does Circumcision Make a Difference?, Sexual Medicine, 3, 2, (76-85), (2015).
  • , Sexual dysfunction in patients with peripheral nervous system lesions, Neurology of Sexual and Bladder Disorders, 10.1016/B978-0-444-63247-0.00011-0, (179-202), (2015).
  • , Does Male Circumcision Adversely Affect Sexual Sensation, Function, or Satisfaction? Critical Comment on Morris and Krieger (2013), Advances in Sexual Medicine, 05, 02, (7), (2015).
  • , Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines, Frontiers in Pediatrics, 3, (2015).
  • , (Im)perishable Pleasure, (In)destructible Desire: Sexual Themes in U.S. and English News Coverage of Male Circumcision and Female Genital Cutting, The Journal of Sex Research, 52, 8, (841), (2015).
  • , Circumcision of Infants and Children: Short-Term Trauma and Long-Term Psychosexual Harm, Advances in Sexual Medicine, 10.4236/asm.2015.52004, 05, 02, (22-38), (2015).
  • , Characterization and Differentiation of Stem Cells Isolated from Human Newborn Foreskin Tissue, Applied Biochemistry and Biotechnology, 177, 5, (1040), (2015).
  • , Adult circumcision and male sexual health: a retrospective analysis, Andrologia, 46, 5, (459-464), (2013).
  • , Can circumcision be a risk factor in premature ejaculation?, Revista Internacional de Andrología, 12, 3, (100), (2014).
  • , The effect of circumcision on young adult sexual function, The Kaohsiung Journal of Medical Sciences, 30, 6, (305), (2014).
  • , Preputioplasty associated with urethroplasty for correction of distal hypospadias: A prospective study and proposition of a new objective scoring system for evaluation of esthetic and functional outcome, Journal of Pediatric Urology, 10, 2, (294), (2014).
  • , Male circumcision decreases penile sensitivity as measured in a large cohort, BJU International, 111, 5, (820-827), (2013).
  • , Relationship between premature ejaculation and postcircumcisional mucosal cuff length, Scandinavian Journal of Urology, 47, 5, (399), (2013).
  • , Effects of circumcision on male sexual functions: a systematic review and meta-analysis, Asian Journal of Andrology, 15, 5, (662), (2013).
  • , Circumcision of male infants as a human rights violation, Journal of Medical Ethics, 39, 7, (469), (2013).
  • , Vaginoplasty using the inner surface or mucosa of the prepuce in children with congenital adrenal hyperplasia, Journal of Pediatric Urology, 9, 6, (1038), (2013).
  • , Relationship between circumcision scar thickness, postcircumcision mucosal cuff length measures and premature ejaculation, Scandinavian Journal of Urology, 47, 4, (328), (2013).
  • , Religious circumcision, invasive rites, neutrality and equality: bearing the burdens and consequences of belief, Journal of Medical Ethics, 39, 7, (450), (2013).
  • , Out of step: fatal flaws in the latest AAP policy report on neonatal circumcision, Journal of Medical Ethics, 39, 7, (434), (2013).
  • , Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis, ISRN Urology, 2013, (1), (2013).
  • , Failed hypospadias in paediatric patients, Nature Reviews Urology, 10, 11, (657), (2013).
  • , Infant male circumcision in the public square: applying the public reason of John Rawls, Global Discourse, 3, 2, (214), (2013).
  • , Circumcision, sexual dysfunction and the child's best interests: why the anatomical details matter, Journal of Medical Ethics, 39, 7, (429), (2013).
  • , Selective resection of dorsal nerves of penis for premature ejaculation, International Journal of Andrology, 35, 6, (873-879), (2012).
  • , Clinical elicitation of the penilo‐cavernosus reflex in circumcised men, BJU International, 109, 4, (582-585), (2011).
  • , REPLY, BJU International, 110, 5, (E161-E161), (2012).
  • , CLINICAL ELICITATION OF THE PENILO-CAVERNOSUS REFLEX IN CIRCUMCISED MEN, BJU International, 110, 5, (E160), (2012).
  • , Correlation Between the Distribution of SP and CGRP Immunopositive Neurons in Dorsal Root Ganglia and the Afferent Sensation of Preputial Frenulum, The Anatomical Record, 294, 3, (479-486), (2010).
  • , Development and Structure of the Glandopreputial Sulcus of the Human Clitoris With a Special Reference to Glandopreputial Glands, The Anatomical Record, 294, 1, (156-164), (2010).
  • , Male genital mutilation: Beyond the tolerable?, Ethnicities, 10, 2, (181), (2010).
  • , CIRCUMCISION, Ashcraft's Pediatric Surgery, 10.1016/B978-1-4160-6127-4.00061-6, (791-795), (2010).
  • , Traumatic neuromas of the penis: a clinical, histopathological and immunohistochemical study of 17 cases, Journal of Cutaneous Pathology, 36, 2, (229-233), (2008).
  • , Bibliography, Hinman's Atlas Of Pediatric Urologic Surgery, 10.1016/B978-0-7216-0645-3.00176-1, (873-923), (2009).
  • , Laser CO2frenuloplasty: A safe alternative treatment for a short frenulum, Journal of Cosmetic and Laser Therapy, 11, 3, (151), (2009).
  • , Peri-rite psychological issues faced by newly initiated traditionally circumcised South African Xhosa men, Journal of Men's Health, 6, 1, (28), (2009).
  • , Rationalization of Indigenous Male Circumcision as a Sacred Religious Custom, Journal of Transcultural Nursing, 20, 4, (395), (2009).
  • , Role of Postcircumcision Mucosal Cuff Length in Lifelong Premature Ejaculation: A Pilot Study, The Journal of Sexual Medicine, 5, 1, (206-209), (2007).
  • , Re: ‘RS Van Howe, FM Hodges. The carcinogenicity of smegma: debunking a myth.’ An example of myth and mythchief making?, Journal of the European Academy of Dermatology and Venereology, 22, 1, (131-131), (2007).
  • , Male genital mutilation: an adaptation to sexual conflict, Evolution and Human Behavior, 29, 3, (149), (2008).
  • , Neonatal Pain Relief and the Helsinki Declaration, The Journal of Law, Medicine & Ethics, 36, 4, (803-823), (2008).
  • , Prepuce‐Sparing hypospadias repair with tubularized incised plate urethroplasty, International Journal of Urology, 15, 8, (720-723), (2008).
  • , THE EFFECT OF MALE CIRCUMCISION ON SEXUAL SATISFACTION AND FUNCTION: RESULTS FROM A RANDOMIZED TRIAL OF MALE CIRCUMCISION FOR HUMAN IMMUNODEFICIENCY VIRUS PREVENTION, RAKAI, UGANDA, BJU International, 101, 10, (1323-1323), (2008).
  • , Extraordinarily high rates of male circumcision in South Korea: history and underlying causes, BJU International, 89, 1, (48), (2008).
  • , FINE‐TOUCH PRESSURE THRESHOLDS IN THE ADULT PENIS, BJU International, 100, 3, (699-699), (2007).
  • , LETTERS TO THE EDITOR: The Forgotten Foreskin and Its Ridged Band, The Journal of Sexual Medicine, 4, 5, (1516-1516), (2007).
  • , Éthique, circoncision et VIH, Sexologies, 16, 4, (309), (2007).
  • , Relation of male circumcision to cervical cancer, sexuality and female circumcision, The Journal of Men's Health & Gender, 4, 4, (448), (2007).
  • , Male circumcision – see the harm to get a balanced picture, The Journal of Men's Health & Gender, 4, 3, (312), (2007).
  • , Factors affecting the outcome of foreskin reconstruction in hypospadias surgery, Journal of Pediatric Urology, 3, 2, (127), (2007).
  • , The effect of male circumcision on sexuality, BJU International, 99, 3, (619-622), (2006).
  • , Fine‐touch pressure thresholds in the adult penis, BJU International, 99, 4, (864-869), (2007).
  • , FINE‐TOUCH PRESSURE THRESHOLDS IN THE ADULT PENIS, BJU International, 100, 1, (218-218), (2007).
  • , A Rose by Any Other Name? Rethinking the Similarities and Differences between Male and Female Genital Cutting, Medical Anthropology Quarterly, 21, 3, (301-323), (2008).
  • , Effects of childhood circumcision age on adult male sexual functions, International Journal of Impotence Research, 19, 4, (424), (2007).
  • , The case against circumcision, The Journal of Men's Health & Gender, 4, 3, (318), (2007).
  • , Amputation du gland lors de la circoncision: A propos de 19 cas, Andrologie, 17, 3, (236), (2007).
  • , Histologic Characteristics of the Human Prepuce Pertaining to its Clinical Behavior as a Dual Graft, Annals of Plastic Surgery, 54, 2, (191), (2005).
  • , Penile Sensitivity and Sexual Satisfaction after Circumcision: Are We Informing Men Correctly?, Urologia Internationalis, 75, 1, (62), (2005).
  • , Male circumcision: a review of the evidence, The Journal of Men's Health & Gender, 2, 1, (21), (2005).
  • , Male neonatal circumcision: indications, controversies and complications, Urologic Clinics of North America, 31, 3, (461), (2004).
  • , Circumcision in adults: Effect on sexual function, Urology, 64, 6, (1267), (2004).
  • , Penile and testicular disorders, Nursing Clinics of North America, 39, 2, (319), (2004).
  • , Lifelong premature ejaculation: from authority‐based to evidence‐based medicine, BJU International, 93, 9, (1360-1360), (2004).
  • , The Prepuce and Circumcision: Dual Application as a Graft, Annals of Plastic Surgery, 52, 2, (199), (2004).
  • , A Cost-Utility Analysis of Neonatal Circumcision, Medical Decision Making, 24, 6, (584), (2004).
  • , Why do male patients request circumcisions?, South African Family Practice, 46, 2, (25), (2004).
  • , Preputial Variability and Preferential Association of Long Phimotic Foreskins With Penile Cancer, The American Journal of Surgical Pathology, 27, 7, (994), (2003).
  • , Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction, The Journal of Urology, 167, 5, (2113), (2002).
  • , Male Circumcision, Penile Human Papillomavirus Infection, and Cervical Cancer, New England Journal of Medicine, 347, 18, (1452), (2002).
  • , Male Circumcision: Pain, Trauma and Psychosexual Sequelae, Journal of Health Psychology, 7, 3, (329), (2002).
  • , Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction, The Journal of Urology, (2113), (2002).
  • , Cost‐effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect, BJU International, 87, 3, (239-244), (2009).
  • , Below the Belt: Doctors, Debate, and the Ongoing American Discussion of Routine Neonatal Male Circumcision, Bulletin of Science, Technology & Society, 21, 4, (297), (2001).
  • , Increased morbidity after circumcision from a hidden complication, BJU International, 88, 9, (938-940), (2002).
  • , Focus on the Foreskin, Not its Destruction, Clinical Pediatrics, 39, 1, (65), (2000).
  • , RE: BOOK REVIEW-SEXUAL MUTILATIONS, The Journal of Urology, 161, 2, (612), (1999).
  • , Male genital mutilation: ‘whodunnit’?, Journal of Clinical Forensic Medicine, 6, 4, (246), (1999).
  • , RE, The Journal of Urology, (612), (1999).
  • , Circumcision of newborn boys, The Lancet, 353, 9153, (670), (1999).
  • , Anatomy and Histology of the Penile and Clitoral Prepuce in Primates, Male and Female Circumcision, 10.1007/978-0-585-39937-9_3, (19-29), (1999).
  • , Uncircumcision: A Historical Review of Preputial Restoration, Plastic & Reconstructive Surgery, 101, 7, (1990), (1998).
  • , Re: Urinary tract infections (UTI) and neonatal circumcision, Paediatrics & Child Health, 3, 5, (305), (1998).
  • , Male Circumcision: A Gender Perspective, The Journal of Men's Studies, 6, 2, (189), (1998).
  • , RE, The Journal of Urology, (2103), (1998).
  • , RE: SOMATOSENSORY EVOKED POTENTIALS IN PATIENTS WITH PRIMARY PREMATURE EJACULATION, The Journal of Urology, 159, 6, (2103), (1998).
  • , A Proposed Relationship Between Circumcision and Neural Reorganization, The Journal of Genetic Psychology, 159, 3, (367), (1998).
  • , Re: Circumcision, The Journal of Urology, 158, 2, (550), (1997).
  • , Re, The Journal of Urology, (550), (1997).